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      Cardiogenic Shock Induced by Anterior Pituitary Hypofunction and Thyrotoxicosis

      case-report
      1 , , 1 , 1 , 1 , 1
      ,
      Cureus
      Cureus
      cardiogenic shock, anterior pituitary hypofunction, thyrotoxicosis

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          Abstract

          Cardiogenic shock occurs when the heart is unable to pump enough blood for the needs of the body. Hypopituitarism is a condition in which the pituitary gland does not produce enough of one or more hormones, and it rarely occurs with thyrotoxicosis. We report a rare case of cardiogenic shock induced by anterior pituitary hypofunction and thyrotoxicosis. A 47-year-old woman was admitted twice to the hospital due to generalized worsening muscle pain for 13 days, and accompanied by a transient loss of consciousness. Cardiogenic shock developed during hospitalization, which improved with active resuscitative measures. Laboratory tests showed thyrotoxicosis. Pituitary magnetic resonance imaging (MRI) and relevant hormone tests confirmed anterior pituitary hypofunction. The patient was given hormone replacement therapy, which stabilized her condition. We believe cardiogenic shock may be a serious complication of hypopituitarism. We recommend establishing an expert system (ES) to facilitate the early diagnosis and treatment of cardiogenic shock, improve the professional skills of primary care physicians, and optimize treatment plans. 

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          Most cited references20

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          2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

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            Update on myocarditis.

            Myocarditis is an inflammatory disease of the heart frequently resulting from viral infections and/or post-viral immune-mediated responses. It is one of the important causes of dilated cardiomyopathy worldwide. The diagnosis is presumed on clinical presentation and noninvasive diagnostic methods such as cardiovascular magnetic resonance imaging. Endomyocardial biopsy remains the gold standard for in vivo diagnosis of myocarditis. The therapeutic and prognostic benefits of endomyocardial biopsy results have recently been demonstrated in several clinical trials. Although remarkable advances in diagnosis, understanding of pathophysiological mechanisms, and treatment of acute myocarditis were gained during the last years, no standard treatment strategies could be defined as yet, apart from standard heart failure therapy and physical rest. In severe cases, mechanical support or heart transplantation may become necessary. There is some evidence that immunosuppressive and immunomodulating therapy are effective for chronic, virus-negative inflammatory cardiomyopathy. Further investigations by controlled, randomized studies are needed to definitively determine their role in the treatment of myocarditis. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                28 December 2020
                December 2020
                : 12
                : 12
                : e12347
                Affiliations
                [1 ] Department of Endocrinology, Shanxi Cardiovascular Hospital, TaiYuan, CHN
                Author notes
                Article
                10.7759/cureus.12347
                7840355
                33520542
                ab9de689-d0a7-40e3-b416-0c95143db423
                Copyright © 2020, Li et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 28 December 2020
                Categories
                Cardiology
                Endocrinology/Diabetes/Metabolism
                Internal Medicine

                cardiogenic shock,anterior pituitary hypofunction,thyrotoxicosis

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